Psychological Resilience and Health-Related Quality of Life in Swedish Women with Newly Diagnosed Breast Cancer

Åsa Mohlin, Ulrika Axelsson, Pär-Ola Bendahl, Carl Borrebaeck, Cecilia Hegardt, Per Johnsson, Ingalill Rahm Hallberg, Lisa Rydén, Åsa Mohlin, Ulrika Axelsson, Pär-Ola Bendahl, Carl Borrebaeck, Cecilia Hegardt, Per Johnsson, Ingalill Rahm Hallberg, Lisa Rydén

Abstract

Purpose: Psychological resilience appears to be an important influencing factor in various aspects of health-related quality of life (HRQoL) in a context of adversity, eg, being informed of a cancer diagnosis. The purpose was to investigate psychological resilience and HRQoL in Swedish women with newly diagnosed breast cancer in relation to demographic and clinicopathological characteristics.

Methods: A population-based cross-sectional study was conducted including 517 women with breast cancer in the South Swedish Health Care Region. Participants were enrolled at the time of consultation for the diagnosis. Psychological resilience was assessed with the Connor-Davidson Resilience Scale 25 (CD-RISC25), and HRQoL was assessed with the Short Form Health Survey. The participants responded to questions regarding demographic variables. Clinicopathological data were collected from the Swedish National Quality Register for Breast Cancer.

Results: The mean score for psychological resilience was 70.6, identifying 15% of included patients with a score lower than 58 (-1 standard deviation). The study cohort had significantly lower mean scores for several aspects of HRQoL compared with Swedish normative data. Regression analyses demonstrated that psychological resilience was significantly associated with all domains of HRQoL after adjustment for demographic and clinicopathological factors.

Conclusion: Higher levels of psychological resilience were significantly related to higher levels of HRQoL in Swedish women with newly diagnosed breast cancer and no modifying factor was identified. The assessment of psychological resilience at the time of breast cancer diagnosis might allow for early identification of women in need of more intense psychosocial support. Future studies are needed to identify a clinically relevant threshold of the CD-RISC25.

Keywords: CD-RISC25; Connor-Davidson Resilience Scale 25; SF-36; Short Form Health Survey; breast cancer; health-related quality of life; psychological resilience.

Conflict of interest statement

Ulrika Axelsson reports grants from Dept of Immunotechnology, during the conduct of the study. The authors declare that they have no other potential conflicts of interest.

© 2020 Mohlin et al.

Figures

Figure 1
Figure 1
Flow chart of the study cohort.
Figure 2
Figure 2
Histogram of total scores for psychological resilience (CD-RISC25) (N = 517).

References

    1. Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and mortality and epidemiology of breast cancer in the world. Asian Pac J Cancer Prev. 2016;17(S3):43–46. doi:10.7314/APJCP.2016.17.S3.43
    1. Izci F, Sarsanov D, Erdogan ZI, et al. Impact of personality traits, anxiety, depression and hopelessness levels on quality of life in the patients with breast cancer. Eur J Breast Health. 2018;14(2):105–111.
    1. Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27(1):32.
    1. Harms CA, Cohen L, Pooley JA, Chambers SK, Galvao DA, Newton RU. Quality of life and psychological distress in cancer survivors: the role of psycho-social resources for resilience. Psycho-Oncology. 2019;28(2):271–277. doi:10.1002/pon.4934
    1. Karlsen RV, Frederiksen K, Larsen MB, et al. The impact of a breast cancer diagnosis on health-related quality of life. A prospective comparison among middle-aged to elderly women with and without breast cancer. Acta Oncol. 2016;55(6):720–727. doi:10.3109/0284186X.2015.1127415
    1. Zhang T, Li H, Liu A, Wang H, Mei Y, Dou W. Factors promoting resilience among breast cancer patients: a qualitative study. Contemp Nurse. 2018;54(3):293–303. doi:10.1080/10376178.2018.1502615
    1. Axelsson U, Ryden L, Johnsson P, et al. A multicenter study investigating the molecular fingerprint of psychological resilience in breast cancer patients: study protocol of the SCAN-B resilience study. BMC Cancer. 2018;18(1):789. doi:10.1186/s12885-018-4669-y
    1. Zhang H, Zhao Q, Cao P, Ren G. Resilience and quality of life: exploring the mediator role of social support in patients with breast cancer. Med Sci Monit. 2017;23:5969–5979.
    1. Haglund ME, Nestadt PS, Cooper NS, Southwick SM, Charney DS. Psychobiological mechanisms of resilience: relevance to prevention and treatment of stress-related psychopathology. Dev Psychopathol. 2007;19(3):889–920. doi:10.1017/S0954579407000430
    1. Ristevska-Dimitrovska G, Filov I, Rajchanovska D, Stefanovski P, Dejanova B. Resilience and quality of life in breast cancer patients. Open Access Maced J Med Sci. 2015;3(4):727–731. doi:10.3889/oamjms.2015.128
    1. Alarcon R, Cerezo MV, Hevilla S, Blanca MJ. Psychometric properties of the Connor-Davidson resilience scale in women with breast cancer. Int J Clin Health Psychol. 2020;20(1):81–89. doi:10.1016/j.ijchp.2019.11.001
    1. Wu Z, Liu Y, Li X, Li X. Resilience and associated factors among Mainland Chinese women newly diagnosed with breast cancer. PLoS One. 2016;11(12):e0167976. doi:10.1371/journal.pone.0167976
    1. Markovitz SE, Schrooten W, Arntz A, Peters ML. Resilience as a predictor for emotional response to the diagnosis and surgery in breast cancer patients. Psychooncology. 2015;24(12):1639–1645. doi:10.1002/pon.3834
    1. Velickovic K, Rahm Hallberg I, Axelsson U, et al. Psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in a non-clinical population in Sweden. Health Qual Life Outcomes. 2020;18(1):132. doi:10.1186/s12955-020-01383-3
    1. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76–82. doi:10.1002/da.10113
    1. The Connor-Davidson Resilience Scale. Available from: . Accessed May 2020.
    1. Windle G, Bennett KM, Noyes J. A methodological review of resilience measurement scales. Health Qual Life Outcomes. 2011;9(1):8. doi:10.1186/1477-7525-9-8
    1. Fradelos EC, Papathanasiou IV, Veneti A, et al. Psychological distress and resilience in women diagnosed with breast cancer in greece. Asian Pac J Cancer Prev. 2017;18(9):2545–2550.
    1. Ristevska-Dimitrovska G, Stefanovski P, Smichkoska S, Raleva M, Dejanova B. Depression and resilience in breast cancer patients. Open Access Maced J Med Sci. 2015;3(4):661–665. doi:10.3889/oamjms.2015.119
    1. Huang Y, Huang Y, Bao M, Zheng S, Du T, Wu K. Psychological resilience of women after breast cancer surgery: a cross-sectional study of associated influencing factors. Psychol Health Med. 2019;24(7):866–878. doi:10.1080/13548506.2019.1574353
    1. Alizadeh S, Khanahmadi S, Vedadhir A, Barjasteh S. The relationship between resilience with self-compassion, social support and sense of belonging in women with breast cancer. Asian Pac J Cancer Prev. 2018;19(9):2469–2474.
    1. Sullivan M, Karlsson J, Taft C, Ware JE. SF-36 Hälsoenkät: Svensk Manual Och Tolkningsguide = (Swedish Manual and Interpretation Guide). Göteborg: Sahlgrenska sjukhuset, Sektionen för vårdforskning; 2002.
    1. Saal LH, Vallon-Christersson J, Hakkinen J, et al. The Sweden Cancerome Analysis Network - Breast (SCAN-B) initiative: a large-scale multicenter infrastructure towards implementation of breast cancer genomic analyses in the clinical routine. Genome Med. 2015;7(1):20. doi:10.1186/s13073-015-0131-9
    1. Rydén L, Loman N, Larsson C, et al. Minimizing inequality in access to precision medicine in breast cancer by real-time population-based molecular analysis in the SCAN-B initiative. Br J Surg. 2018;105(2):e158–e168. doi:10.1002/bjs.10741
    1. Swedish National Quality Registry for Breast Cancer (NKBC). Available from: . Accessed May 2020.
    1. Statistics Sweden. Surveys about living conditions (ULF/SILC). Available from: . Accessed November4, 2020.
    1. Sullivan M, Karlsson J, Ware JE Jr. The Swedish SF-36 health survey–I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med. 1995;41(10):1349–1358. doi:10.1016/0277-9536(95)00125-Q
    1. Sackey H, Sandelin K, Frisell J, Wickman M, Brandberg Y. Ductal carcinoma in situ of the breast. Long-term follow-up of health-related quality of life, emotional reactions and body image. Eur J Surg Oncol. 2010;36(8):756–762. doi:10.1016/j.ejso.2010.06.016
    1. Dooley LN, Slavich GM, Moreno PI, Bower JE. Strength through adversity: moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors. Stress Health. 2017;33(5):549–557. doi:10.1002/smi.2739

Source: PubMed

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